[Etiologic diagnosis of pneumonia in HIV-AIDS patients. Usefulness of fibrobronchoscopy].

AIM: to assess the usefulness of fiberoptic bronchoscopy in the etiologic diagnosis of pulmonary infiltrates in patients with AIDS.

PATIENTS AND

METHODS

in 25 patients with AIDS and pneumonia, 31 fiberoptic bronchoscopies with bronchoalveolar lavage were performed; in 11 occasions, a transbronchial biopsy was also performed.

RESULTS

in 24 of the 31 procedures (77%) an etiologic diagnosis was made. There were 7 false negative results; in two of these patients, a repeated examination allowed an etiologic diagnosis. The etiologies of the infiltrates were pyogenic bacteria in 14 cases. Pneumocystis carinii in 9, mycobacteria in 3, cytomegalovirus in one and a lymphocytic interstitial pneumonia in one. In 5 patients, the association of two or more etiological agents was observed. Except one case, all patients had a good response to specific treatments. There were no complications attributed to the bronchoscopic procedure.

CONCLUSIONS

fiberoptic bronchoscopy and bronchoalveolar lavage are safe and effective procedures for the etiologic diagnosis of pulmonary infiltrates in patients with AIDS.